Individual
SHAQUANA D BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4808 STONEY TRACE DR APT K, MINT HILL, NC 28227-6098
(704) 574-4687
Mailing address
4808 STONEY TRACE DR APT K, MINT HILL, NC 28227-6098
(704) 574-4687
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
NC
172A00000X
Driver
—
—
Other
Enumeration date
10/28/2021
Last updated
10/28/2021
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